Provider Demographics
NPI:1255054847
Name:NAVARRO, JENNIFER GAYLE (APRN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:GAYLE
Last Name:NAVARRO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 RED HAVEN LN
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-2000
Mailing Address - Country:US
Mailing Address - Phone:407-747-1147
Mailing Address - Fax:
Practice Address - Street 1:15701 STATE ROAD 50 STE 101
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-9203
Practice Address - Country:US
Practice Address - Phone:407-347-8287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-20
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9265169363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily